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Pain Specialist not much help....need advice

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:26 AM in Chronic Pain
Hello everyone,

I just discovered this site and my heart goes out to all of of you. I had a spinal fusion and lamenectomy 3/06. I also suffer from fibromyalgia. I had a very caring physician and was prescribed hydrocodone. I saw her once a month to make sure that I was monitored properly. We went through a period that we adjusted my medications and all was fine. I then thought I might benefit from a "pain specialist" to see if there was something other than controlled substances to help with my pain.

I have never been treated to disrespectfully in my life. They could not beleive that I was taking hydrocodone for 3 years and treated me like a drug addict. They pretty much scolded my primary care physician and put me on Kadian 20mg. The Kadian doesn't help at all and after begging to adjust the dosage they finally swithced it to 30mg, but still severe pain. They had mr try Lyrica, which made me feel stoned out of my mind. I asked my previously compassionate primary care doctor to help me and go back to my previous treatment, but she refuses and says that I have to be treated by the pain specialist.

I know that this is very long, but I am desperate and in excruciating pain. After reading so many posts and seeing the many different controlled substances that so many are on, I would like to know how is everyone prescibed meds that help them and I can't. When I was on hydrocone, I functioned so much better. I was able to drive and perform daily tasks. Now, with Kadian I am in so much pain and am tired and loopy. Please help!

Thank You,

Witts End



  • Hello Witts End,Welcome to S~H :H

    What is it exactly that you would like to try as far as medications go?You said here that:
    I would like to know how is everyone prescibed meds that help them and I can't.
    In the beginning of your post you mentioned that;
    I had a very caring physician and was prescribed hydrocodone. I saw her once a month to make sure that I was monitored properly. We went through a period that we adjusted my medications and all was fine. I then thought I might benefit from a "pain specialist" to see if there was something other than controlled substances to help with my pain.
    I'm just a bit confused why you left your primary care physician in the first place for something other than a controlled substance to go to a "pain specailist?"

    Just curious.Welcome to S~H.

  • :D hi and welcome to the forum! :H we are here to offer you support and answer what questions we can. maybe you just need to start fresh with a new pm doctor. if this one is not treating you as you like, your best bet might be a new one. good luck as you seek pain relief. Jenny :)
  • Hi :H Welcome to Spine Health. I feel for you and your situation. I know it can be frustrating when your meds are at a level that are meeting your needs. I have been on Lyrica for 1 year. At first I also felt loopy, or as I saw it as extremely dizzy. Once my body got used to it, I found it to be a decent drug, but that is just my experience. I realize we all respond to meds in different ways, and require diffent dosages. If you are not pleased with your pain specialist why can't you simply not go anymore, and return to care with your Primary Care Physician? Just a question...best wishes, and I hope you enjoy SH like I do.
    Blue (8)
  • Hi Robin,

    I meant that the Hydrocodone worked for me, with the least amount of side effects and I would like to go back on it. However,my pain specialist refuses to prescibe it and says it's highly addictive, but doesn't seem to think that Kadian isn't a problem? My primary care physician is still my primary care physician, but she want's the pain specialist to treat my pain and not go against his wishes.

    I was told that the pain specialists had alternative forms
    of meds other than narcotics.

    I was better off before I went to the specialist.
  • Hi Blue,

    Thank you for your reply. I would love to have my primary care physician take back over my pain managemment, but since the pain specialst got involved, she doesn't want to anymore.
  • Sorry you are in so much pain. I know from experience, Hydrocodone can be very addictive. At least in my experience I could see where I would have a problem going off of it.

    I asked my Dr. for something stronger, and he prescribed oxycodone. I always thought that was one of the most addictive drugs there is, and it may be to some people. I get no feelings from it other than relief from pain, and tiredness.

    Hydrocodone is another matter for me. Even though it is a somewhat weaker pain killer, it gives me a high feeling. A good high I might add. I can work, I have energy, it helps with the pain, and I have no side effects. I consider it a miracle drug, at least for me. I just need something that takes the pain away more effectively.

    If these Drs. that give patients a hard time, had ever been in the unending, depressing pain that most of us have to deal with, then maybe they would see things differently.

    Hope things work out for you.

    Robert in NC
  • Witts End,

    The first three neuro drs. I saw treated me like crap! The last one begrudgingly gave me 5mg of hydrocodone. I was in so much pain that I was clenching my teeth all day and night. I would have to stay up at night until I was so exhausted that I was falling asleep on the sofa (around 3:00 am). When I was finally was exhausted enough to go to bed I would sleep with my hands and teeth clenched. My husband would wake up in he morning and see I was sound asleep but my face was totally contorted in pain.

    The last time I saw the nazi neuro I was so exhausted that I started crying saying how much pain I was in. I thought he treated me bad before, this time he started YELLING at me! That I was depressed, hooked on drugs and that I needed psychological counseling. (Well, yeah, duh! I'm in horrible pain, I don't sleep, I don't have a life any more and oh, yeah, I'm seeing you, you nazi freak!) I thought he was going to have me committed right then and there. I felt lucking that he even let me walk out of his office!

    I walked out of there and called my husband. Husband flipped! Called our family dr. and got an appointment with him the following day. My family dr. looked at my mri and wanted to know what any of these past three neuros said about my 2 crushed discs, bone spur and 2 bulging discs. I said not one of them addressed those issues but talked about my hip and facet joints. My family dr. got me an appointment with one of the best neuros in the area.

    When I went in and saw this 4th neuro he looked at my chart and said it was CRIMINAL that I had been in that kind of pain for 2 years and had to fight for hydrocodone. He wrote me a script for 20mg of oxycotin.

    My husband now goes to every doctors appointment with me.

    We talked about this somewhere else on this board. If you're a woman you need a man to go to your appointments with you. As disgusting as that sounds, unfortunately it's true.

    I'd go back to your first dr. with your spouse, partner or even a sibling and have them there as an advocate for you!

    Best wishes.
  • You can find a 2nd PM Dr. My first one was rude to me. I was looking up his name online because he was involved in a study with the infrared platinum heating pad and helps heal annular tears but of course not everyone would be healed. Anyway, I found he was charged with several offenses and was suspended from work for 2 and a half years! Yikes, so that must've been cleared because he was working. So I went to another PM Dr. who is very nice. But, I want to say about the meds, my Dr. started me on MS Contin and had to increase it recently to 30mg every 6 hours. The pain management Dr. said I could take it 60 mg twice a day. I take 60mg in the morning then 1 at 6pm and one at bedtime. I have leftover percocet but only take very rarely. Long acting meds are better because there's no euphoria only pain relief and less risk of addiction. Lyrica has side effects at first and usually resolve within a month. I hope you can work with another Dr. if this one is not listening that you have more pain than what the pain meds he gives aren't working. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Thank you so much EM!!!!!!!!!!!
  • a huge post and it disappeared. I hate when that happens!

    Well, I understand your frustration but also understand why these docs are switching you over. You clearly have a long-term pain problem and they are now giving you long-acting pain meds. Just too little of a dose.

    Have you checked online conversion charts? How much HC you were on versus how much Kadian now, to give you an idea how far apart they are?

    I have been in PM since July, and even today, just had a med adjustment. I see her monthly and we adjust or we don't, just depends. I am willing to live at a 5 out of 10 on the pain scale, and because my doc finds me to be so reasonable, she has no issues increasing my doses. I also just got the SCS (spinal cord stimulator) on Monday so I am very hopeful. There is just very little they can do for permanent nerve damage, which I have.

    Also, have you kept a pain diary? You could do that for a few weeks and take it with you to show your new doc. If he sees your expectations are reasonable YET you show him how much pain you are in, when and why, you may get farther. If not, definitely find a new doc.

    Good luck,

  • You might try and ask your PCP for a referral to another pain specialist, since there are many out there and not all have the same views regarding narcotics. Worth a try! Best of luck to you, and remember, its one day at a time!
  • Yes well,all narcotics are addictive,and anyone taking them for any prolonged period are going to become dependant.There is a difference between dependance for pain relief and addiction.The pain sp. knows this,so I have no idea what he/she is doing in that type of treatment center.

    Your primary care Dr can no longer treat you for pain even if she wants to now that you are being treated by a pain sp.Maybe if you just quit with the pain Dr she may be willing to treat you.I'm not suggesting that you do this,only speculating because your primary care may not have told you but she is protecting herself in this situation.It is illegal to get pain medication from more than one Dr if it is a scheduled medication.Both your primary and your pain Dr know this-but you may not,and that might be adding to your confusion.

    A lot of us here on S~H know all of this and have been where you are now in looking for a good Dr to treat our pain.Actually I've been pretty lucky,but some others have been in-between Drs and searching for a good Dr.

    Your Dr knew obviously that you took the hydrocodone though,and I would think that she would refer you to a pain Dr that could do MORE for you than she could do or was willing to do.Maybe that was her intention and she was not sure what your needs were?

    My best advice is to be patient,reasonable,and above all,honest with your Drs-and you are more likely to get the treatment and care that you need.

  • Definitely get a new doc. Never settle for one that is not helping you. Be persistent and do not give up until you find one that you are comfortable with and will help you. Good luck and please keep us posted.
  • Witts End,
    It is never easy changing medication that at one time helped and it is of no assistance that others seem to be having some relief and you do not. Specialist pain care is always more preferable and new strategies take some adjustment and waiting in pain never easy. Changing practitioner is only appropriate when they suggest it and doing so continually only see’s you as the problem rather than your condition, I do understand that you need a good working relationship and be harmonious in your collective decision making process.

    If the doctor were to concede to your view then he would not be doing his job and however frustrating the waiting becomes all of this takes time. I am never pain free and it is a misconception that others are, they are dealing with it the best way they can, as you know from experience all medication comes will proportionate and at time progress side-effects and it is finding the balance and quality of life you can live with. We all go in with expectation of what is perceived could be of help and my opinion is that in medication alone will not give the desired results, Melzack & Wall the pain guru’s suggest that a collective approach to pain management is the most effective, from an array of tools and improving strategies.

    Could you ask him to explain the reasons why he thought a new medication would be more effective and what are his plans for the future, the pain record is a good suggestion and provided factual evidence of the effectiveness of this new regime over time? What short term goals do you have.

    Take care, many here have been where you are now and continue to progress.

  • kadian is time release morphine, I used to take 100 mg of it twice a day for pain but had nightmares and went back to oxycontin. I don't understand your dr. why is he concerned about vicodin when morphine is more addictive? if he was concerned about addiction he would keep you on vicodin and not put you on morphine. by the way hydrocodone is generic vicodin and kadian is time release morphine. this seems weird to me. get another dr and ask him to put you on vicodin if you don't like the kadian. you don't have to stay with this guy. go on line and look for a new pain dr. why do you stay with this guy if he makes you unhappy. a lot of people complain about pain drs who are not compassionate and they stay with them. you don't have to. there are plenty of pain drs around and if in your area there are not that many go to another city. i used to drive 200 miles to see mine when he moved to lake tahoe
    good luck
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • Anyone here who knows me knows I have had an unusual number of bad experiences with pain docs. I do believe it is important to find someone with whom you really click. If you are going to have pain the rest of your life, then you'll need a pain doc for the rest of your life so the choice of doctors is a very important one. I, too, take a "short-acting" pain med. I do not tolerate narcotics. For some reason they make me feel really agitated, hyper, almost panicky. Generally speaking, it has been explained to me, a doctor would rather have you on a long-acting drug. With short acting pain meds, you are going to be experiencing pain as the drug starts to wear off in three hours or so until its time to take another one. A long-acting drug will prevent you from having the constant ups and downs of pain relief. Every pain doc I've seen has tried to find a long-acting drug I could tolerate. That part does make sense. Just a thought. Here at S-H, when someone writes with a problem, we all respond that we are sorry that you are having that problem WHAT IF....the pain doctors office would treat us similarly. WHAT IF....when we called in horrible pain (instead of thinking we are drug seeking), the nurse on the other end of the phone would say, "I'm so sorry your feeling bad". Wouldn't that be great? Susan
  • I'm sorry you're having a tough time with your PM doctor. A reason why your PCP won't prescribe hydrocodone anymore is because of DEA regulations. She rather have you at a pain clinic than to arise their suspicion, and this is very common practice with family doctors. She also thinks that you need a stronger medicine to manage your chronic pain. The PM doc can also give you a break through medicine to take alongside the Kadian like hydrocodone or oxycodone. I'm on Fentanyl patches and it is a strong long acting narcotic. I also am on Norco (hydrocodone)which is slightly different than Lortab (hydrocodone) because the tylenol content is 325mg instead of 500 mg and is easier on the liver.
    If you can't get through to your PM doctor, then you should find another who will listen better. PM docs are more experienced in dealing with chronic pain and medications than family docs are.
  • You have to give the new Dr a chance too though-to get to know you and your pain/body.If we are being honest here we should admit or need to be aware that it's not good to change Drs frequently-without really good cause.Not getting the medications that we think we should,or that a person wants is not a good reason to change Drs.

    It takes time to build up a relationship with a pain Dr-he/she has to understand the best way to treat your pain.Also,in this society there are trust issues that go hand in hand with scheduled drugs.I believe that once we face that as fact and learn to accept it as such,it becomes a lot easier in understanding where the Drs are coming from and having some respect for what we ALL have to go through to be taken seriously and treated with respect.

    When you walk into your Drs office for the first time you are as much a stranger to him as he is to you,but you have only the one PM-he has many patients,and many haven't been honest with him.How many guys have broken your heart and how long did it take you to trust again..The PM is'nt a BF-you don't just walk out when things aren't working..at least not right away.The paper trail won't look good.
  • hi all
    i take oxycodone and it has been a life saver for me .like one of the other people that has posted on this post i too don't get high on it because if you are in pain your body uses the drug to control the pain {whereas if you took it with no pain you would get high .{that advice from my doctor}you will find though that if you should ever run out of it you WILL feel lousy withdrawn and i horrible pain..i know as i have ran out once!.i have found it to be the best for pain control.better than morphine ..also pain doctors can be difficult to find a good sympathetic one.again i know as i have has some right baxxxxds!!.the one i have now is very caring so if you are not happy with the one you have change ...life is too short my friend
  • Just wanted to give everyone an update. My pain doctors physicians asst. finally adjusted my Kadian to 50 mg 2x's daily and said that this better work, because he isn't willing to go higher and also Tramadal for breakthrough pain (but does nothing for me). My rheumatologist asked me to try Lyrica again 50 mg at bedtime. I am doing much better, but there are still times that I am in pain. It's been almost 2 weeks on Lyrica and am very sleepy. I don't know how much longer I can take of sleeping all the time (and I have a 4 year old). Is anyone on Lyrica and does the sleepiness go away within a month?

  • I understand your frastrution and I feel for you. Not easy to leave in severe pain 24/7. My road to find good Doctors wasn't easy either. But I refuse to give up and think that they all the same. Unfortunately not every Dr has knowledge, compassion for his patients; you have to find the one who really knows and cares. I am under my PM care for a bit more than 3 years by now and yes, I am on Pain medication. It was changed many times due to doses, allergic reaction, etc. I have to go to NYC every month to see him, he monitors my issues, sends me to have more tests, MRI's if needed and adjusts my medication if needed. As you probably know, PM Dr usually makes contract with his/her patients. By this contract you can't fill prescriptions from any other Drs for PK and also if they have any concerns they can send you to have blood or urine tests done and you must comply with it.
    So far I have no problem with my DR; I can say only good things about him and his treatments. Respect is mutual. I had never been mistreated or my prescription was late for fill in. When I had terrible reaction to Fentanyl patch, he called for ER service for me and was with them on a phone all night until I got better. When I came home, he called me every single day for one week to check on me.
    Please, don't think I was this lucky to find one from the first time I needed. I had my fare share of bad experiences. I got so disapointed and decided to go to see highly recommended PM even though he doesn't participate any insurances. I immideately saw the difference between good Dr and the once I had before. Despite the fact that my insurance covers only 70% of my bills (out of net-work) and the fact that I am on disability, I still decided to stay with him. So worth it to have a Dr who you can trust, who cares and who is there for you when you need him.
    Best of luck to you, dear heart!

  • Hi

    Septicaemia damaged my left foot. Most of the joints are gone, e.g. bone to bone. Some have fused by themselves but some have not causing me a terrible pain.
    Until now I have been eating painkillers and anti-inflammation drugs daily. If I don´t I can barely walk.

    But now my life is changing for the better. I came accross this unbelivable product. First I just did not believe it, but with pain like have, you are willing to try anything. And I did. This is just amazing. Nano-plaster. I registered with them and these are just fantastic - i really mean it. The future is now. I can now walk about almost with no pain without eating drugs.
    Take a look at www.edited

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